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Clinical Manifestations.

Fleur H C van der Linden1, Kaitlin B Casaletto2, Argentina Lario Lago1

  • 1Memory and Aging Center, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 26, 2025
PubMed
Summary
This summary is machine-generated.

Behavioral variant Alzheimer's disease (bvAD) patients exhibit pre-morbid personalities similar to healthy controls, unlike typical AD (tAD). Post-onset, bvADs develop rigid personalities, mirroring behavioral variant frontotemporal dementia (bvFTD).

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Gerontology

Background:

  • Behavioral variant Alzheimer's disease (bvAD) presents with symptoms similar to behavioral variant frontotemporal dementia (bvFTD) but has anatomical links to typical Alzheimer's disease (tAD).
  • Pre-morbid personality traits may predispose individuals to bvAD, leading to early behavioral deficits during neurodegeneration.
  • Personality characteristics, both pre-morbid and current, have not been well-defined in bvAD patients.

Purpose of the Study:

  • To investigate and compare pre-morbid and current personality traits in patients with bvAD.
  • To explore the relationship between personality and the development of distinct behavioral phenotypes in neurodegenerative diseases.
  • To determine if personality changes observed in bvFTD are also present in bvAD.

Main Methods:

  • A retrospective case-control study involving 19 bvAD patients, 25 tAD patients, 28 bvFTD patients, and 37 healthy controls (HCs).
  • Personality was assessed using the informant-based Interpersonal Adjective Scale (IAS) to measure pre-morbid and current traits.
  • Statistical analyses included ANOVA, Kruskal-Wallis, paired t-tests, and Wilcoxon rank tests to compare personality dimensions and vector lengths between groups and over time.

Main Results:

  • Pre-morbidly, bvAD, bvFTD, and HC groups exhibited lower warmth and higher ingenuousness compared to tAD.
  • Following symptom onset, bvAD and bvFTD patients showed significant decreases in warmth, extroversion, and dominance.
  • Both bvAD and bvFTD groups displayed increased personality rigidity (vector length) post-symptom onset compared to tAD and HCs.

Conclusions:

  • bvAD patients share a pre-morbid personality profile with HCs and bvFTDs, distinct from tAD patients who are characterized by higher warmth.
  • After disease onset, bvAD patients develop a rigid personality, similar to that observed in bvFTD.
  • These findings highlight the role of pre-morbid personality in shaping neurodegeneration-induced behavioral phenotypes and indicate that significant personality shifts are not unique to bvFTD.